Statins and diabetes risk: Fact, fiction, and clinical implications

Statin drugs now carry a US Food and Drug Administration warning that they may increase the risk of diabetes mellitus and may worsen glycemic control in patients who already have diabetes. Though the association is clear, until some contradictory observations can be resolved and plausible mechanisms of action elucidated, causality cannot be established. From a clinical standpoint, there is currently no evidence that elevations in blood glucose while taking lipid-lowering drugs are associated with an increased risk of cardiovascular events or that they attenuate the beneficial effects of the therapy. Until further study is done, statins should continue to be used based on a careful assessment of risk and benefit.